RESIDENT-FOCUSED CARE IN A HOME-LIKE SETTING

Kensington Health Centre (KHC), located in the Kensington Market district of downtown Toronto, is a not-for-profit healthcare organization focused on health and wellness services for people of all ages. Kensington Gardens, which comprises two of KHC’s three buildings, is a comprehensive, 350-bed long-term-care facility devoted to providing resident-focused care to senior citizens in a home-like setting.

PCC INTEGRATES CLINICALS & FINANCIALS

Since June, 2002, KHC has been using the PointClickCare (PCC) suite of applications for online clinical documentation and to integrate its clinical and financial management activities. PCC brought a new level of efficiency to KHC’s billing process; and with PCC’s single-system, single-database approach, 150 KHC users can all access the same data at the same time, in real time, ensuring consistency and enhancing management confidence in the validity and accuracy of both clinical and financial data. Subscribing to PCC as a hosted, Web-based solution has enabled KHC to avoid all the infrastructure costs, maintenance headaches, backup effort, and software upgrade challenges typically required to support in-house systems.

LEGACY MAINTENANCE MANAGEMENT PROCESS INEFFICIENT

To address daily ‘environmental services’ requirements – maintenance, housekeeping, dietary and laundry – KHC uses Sodexo, Inc., a leading provider of integrated food and facilities management services in Canada and around the world. However, the process being used by KHC to manage its facility and equipment maintenance activities was highly inefficient and the source of numerous problems for KHC and Sodexo staff, as well as concern by residents and their families.

The process was based on the use of 17 hardcopy Work Order binders spread throughout the two buildings – two on each of the seven floors, one at each of the two receptionist locations and one in the main kitchen.If nursing staff, managers or other KHC employees discovered, or had reported to them by a resident or family member, a problem with the facilities (lighting, plumbing, HVAC, etc.) or the equipment (beds, resident lifts, dishwashers, fridges, freezers, stoves, etc.), they were supposed to fill out a form in the nearest Work Order binder. At the beginning of each shift, the maintenance person on duty would walk from floor to floor throughout both buildings, checking each of the 17 binders for any new work requests, which would then be handled accordingly.

“If a request was entered into a Work Order binder at say noon on one day, it might not be seen by Maintenance until 7:00 a.m. the next morning when they next did their rounds,” claims Rhonda Obiero, a Sodexo employee assigned to KHC as Director of Support Services. “This left us exposed to complaints by residents and families that we were not taking care ofthings in a timely fashion.”

When a new work order was found, additional time was spent going back to the maintenance shop to get necessary tools and parts and then returning to the floor to make the repair. These problems were compounded by the fact that the Work Orders, which were handwritten, were often hard to read, and didn’t provide sufficient detail, requiring the maintenance technician to inspect the problem to determine what was required to fix it. To top things off, maintenance staff would, on some occasions, neglect to go back to the Work Order binder to signoff that a task was complete, or would inadvertently leave out important information such as the date and time the problem was resolved – all of which only served to make maintenance more difficult to monitor, track and report on with any degree of confidence.

MAINTENANCECARE PILOT YIELDS DRAMATIC RESULTS

To automate its maintenance management process and to bring new levels of accuracy and integrity to maintenance activity and safety tracking data, KHC undertook a pilot implementation of the MaintenanceCare application from property management software vendor GNXCOR. Like PointClickCare, MaintenanceCare is a fully hosted, Web-based application accessible over the Internet by subscription following the software-as-a-service model.

Nursing staff and maintenance supervisors were already using computers to access PCC and thus could also easily access MaintenanceCare. Maintenance technicians, however, were not using computers previously, so as part of the pilot implementation, they were issued Blackberries so they could receive the Work Orders automatically e-mailed to them by MaintenanceCare. As a result, nursing staff, for example, can simply click on an icon on their computer screen to log into MaintenanceCare and enter a problem, and in just a few moments, it is in the hands of the maintenance techs – no more time-consuming, manual process, no more binders spread all over the facility and no more hardcopy Work Orders that need to be filled out and signed off. “Before, we were averaging about 90 Work Orders a month; but now, with MaintenanceCare running, we average roughly 250 to 300 per month,” says Obiero, illustrating that before the pilot, many problems were simply being phoned in to Maintenance by Nursing staff, without proper Work Orders being completed and added to the binders. “With better, online documentation capability and with staff getting accustomed to the new system, this problem has virtually gone away.”

With the management of all maintenance activity completely online and quickly and easily accessible, there is no longer a need for supervisory staff to collect and count Work Orders as before to generate monthly statistics or manually enter the data into PointClickCare. MaintenanceCare integrates with PointClickCare, so all it takes is a click of a button and the required data in MaintenanceCare flows into PCC’s QIA module – no more gathering up, sorting and counting up hardcopy Work Orders.

“With MaintenanceCare, we can view a whole year’s worth of maintenance activity at a time, spread monthly,” enthuses Obiero. “We can easily see where there may be variances against specific safety incident measures and targets, for example, as well as other performance measures.”

PREVENTIVE MAINTENANCE TASKS FULLY SCHEDULED

KHC is also taking full advantage of the Preventive Maintenance (PM) capability within MaintenanceCare. Required PM tasks are all set up in the application’s Scheduler, which automatically generates an alert whenever a PM activity comes due. Previously, PM tasks were put onto a regular Microsoft Outlook calendar, printed out and simply posted in hardcopy in each building. “Individual tasks weren’t being assigned to specific maintenance staff or scheduled to be done on specific shifts, so we weren’t sure whether they were being done properly or on time,” admits Obiero, “but now that Preventive Maintenance is all set up in MaintenanceCare and we can schedule specific dates and shifts, I think the staff is a little more accountable for getting things done in a timely fashion.”

ASSET MANAGEMENT REIGNS-IN REPAIR COSTS

As the last phase of its MaintenanceCare pilot, KHC is implementing the Asset Management component.

“I had a strong suspicion we were spending way too much on equipment repairs,” says Obiero, describing one example of how, after three years, when all the warranties had expired, their dishwashers were breaking done on a regular basis, causing considerable inconvenience to staff and resulting in expensive repair bills.

“Using MaintenanceCare’s asset management capability, it will be easy for us to capture and track all the information about assets, invoices, purchase and lease costs, repair costs and so on,” claims Obiero. “So when it comes time to look at capital expenditures and put my equipment requirements list together, I’ll be able to see, for example, what our costs really are and whether it might be time to replace an old piece of equipment, or perhaps lease a new one instead of buying it.”

MAINTENANCECARE DELIVERS MANAGEABILITY & SERVICE

“MaintenanceCare is putting better information at our workers’ fingertips and helping us promote best practices throughout our organization,” claims Bill O’Neill, Executive Director, Kensington Health Care Centre, adding that while the new system may not be generating huge cost savings, their money is now being better spent because nursing and maintenance staff time is being used more efficiently. “It is also having a significant impact on customer service, and safety-related issues are now better monitored, tracked and reported,” he concludes.